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      Neuropsychological assessment of patients with fibromyalgia Translated title: Avaliação neuropsicológica de pacientes com fibromialgia Translated title: Evaluación neuropsicológica de los pacientes con fibromialgia

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          Abstract

          The aim of the present study was to investigate associations among symptoms of depression, anxiety, pain perception and cognitive impairment in patients with a diagnosis of fibromyalgia. We evaluated 32 women volunteers with a diagnosis of fibromyalgia based on the criteria of the ACR. The control group was matched to the patient group for age, schooling and income. The volunteers were submitted to a neuropsychological battery focused on Memory, Attention, Executive Functions, Perceived Pain, Anxiety and Depression. Anxiety was more relevant than depression in the group of women with fibromyalgia, the perception of pain was very high and cognitive impairment was more evident in executive functions, especially planning and inhibitory control. Memory and attention were more impaired in the fibromyalgia group, especially on tasks that require executive functions. Patients with fibromyalgia seem to be less efficient in tasks related to executive functions.

          Translated abstract

          O escopo desse artigo é a investigação das associações entre sintomas de depressão, ansiedade, percepção da dor e déficits cognitivos em pacientes com diagnostico de fibromialgia. Avaliamos 32 mulheres com diagnósticos de fibromialgia segundo a ACR. O grupo controle foi equiparado em termos de idade, escolaridade e renda. Todas as voluntárias foram submetidas a uma bateria neuropsicológica focada em Memoria, Atenção, Funções Executivas, Dor Percebia, Ansiedade e Depressão. Ansiedade foi mais relevante que depressão para o grupo de mulheres com fibromialgia, ao mesmo tempo os níveis de dor foram mais altos e os prejuízos cognitivos mais evidentes foram relacionados às funções executivas, principalmente controle inibitório e planejamento. Memória e atenção estavam mais prejudicadas no grupo fibromialgia, principalmente naquelas tarefas que requisitam mais das funções executivas. Pacientes com fibromialgia parecem menos eficazes em tarefas relacionadas às funções executivas.

          Translated abstract

          Investigar las asociaciones entre los síntomas de depresión, ansiedad, percepción del dolor y deterioro cognitivo en pacientes con diagnóstico de fibromialgia. Se evaluó a 32 mujeres voluntarias con un diagnóstico de fibromialgia según la ACR. El grupo de control fue emparejado con el grupo de pacientes por edad, escolaridad e ingresos. Los voluntarios fueron sometidos a una batería neuropsicológica enfocada en Memoria, Atención, Funciones Ejecutivas, Dolor Percibido, Ansiedad y Depresión. La ansiedad fue más relevante que la depresión en el grupo de mujeres con fibromialgia, la percepción del dolor fue muy alta y el deterioro cognitivo fue más evidente en las funciones ejecutivas, especialmente en la planificación y el control inhibitorio. La memoria y la atención estaban más afectadas en el grupo fibromialgia, especialmente en las tareas que requieren funciones ejecutivas. Las pacientes con fibromialgia parecen ser menos eficientes en tareas relacionadas con las funciones ejecutivas.

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          Most cited references34

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          A modified card sorting test sensitive to frontal lobe defects.

          H Nelson (1976)
          Milner's (1963) report of impaired performance on the Wisconsin Card Sorting Test (WCST) in a group of patients with frontal lobe lesions suggested that this test might be a useful one in the investigation of individual patients with suspected brain lesions. However, for many of our older hospital population the WCST was found to be too difficult and distressing, and also the inherent ambiguities associated with certain responses limited the test's usefulness for research purposes. Therefore, a simpler and less ambiguous modification was devised (MCS) and a new method of measuring perseverative errors proposed. In a group of 53 patients with unilateral cerebral lesions, those with frontal lobe lesions performed less well with the MCST and made a higher proportion of perseverative errors than those with lesions elsewhere: there were no laterality effects in either frontal or non-frontal groups. The usefulness of the MCST for detecting frontal lobe lesions in individual patients was established, and the use of cut-off scores briefly discussed.
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            Accelerated brain gray matter loss in fibromyalgia patients: premature aging of the brain?

            Fibromyalgia is an intractable widespread pain disorder that is most frequently diagnosed in women. It has traditionally been classified as either a musculoskeletal disease or a psychological disorder. Accumulating evidence now suggests that fibromyalgia may be associated with CNS dysfunction. In this study, we investigate anatomical changes in the brain associated with fibromyalgia. Using voxel-based morphometric analysis of magnetic resonance brain images, we examined the brains of 10 female fibromyalgia patients and 10 healthy controls. We found that fibromyalgia patients had significantly less total gray matter volume and showed a 3.3 times greater age-associated decrease in gray matter than healthy controls. The longer the individuals had had fibromyalgia, the greater the gray matter loss, with each year of fibromyalgia being equivalent to 9.5 times the loss in normal aging. In addition, fibromyalgia patients demonstrated significantly less gray matter density than healthy controls in several brain regions, including the cingulate, insular and medial frontal cortices, and parahippocampal gyri. The neuroanatomical changes that we see in fibromyalgia patients contribute additional evidence of CNS involvement in fibromyalgia. In particular, fibromyalgia appears to be associated with an acceleration of age-related changes in the very substance of the brain. Moreover, the regions in which we demonstrate objective changes may be functionally linked to core features of the disorder including affective disturbances and chronic widespread pain.
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              Working memory performance is correlated with local brain morphology in the medial frontal and anterior cingulate cortex in fibromyalgia patients: structural correlates of pain-cognition interaction.

              Fibromyalgia (FM) is a disorder of unknown aetiology, characterized by chronic widespread pain, stiffness and sleep disturbances. In addition, patients frequently complain of memory and attention deficits. Accumulating evidence suggests that FM is associated with CNS dysfunction and with an altered brain morphology. However, few studies have specifically investigated neuropsychological issues in patients suffering from FM. We therefore sought to determine whether neuropsychological deficits found in FM patients may be correlated with changes in local brain morphology specifically in the frontal, temporal or cingulate cortices. Twenty FM patients underwent extensive testing for potential neuropsychological deficits, which demonstrated significantly reduced working memory and impaired non-verbal long-term memory (limited to free recall condition) in comparison with normative data from age- and education-matched control groups. Voxel-based morphometry (VBM) was used to evaluate for potential correlations between test results and local brain morphology. Performance on non-verbal working memory was positively correlated with grey matter values in the left dorsolateral prefrontal cortex, whereas performance on verbal working memory (digit backward) was positively correlated with grey matter values in the supplementary motor cortex. On the other hand, pain scores were negatively correlated with grey matter values in the medial frontal gyrus. White matter analyses revealed comparable correlations for verbal working memory and pain scores in the medial frontal and prefrontal cortex and in the anterior cingulate cortex. Our data suggest that, in addition to chronic pain, FM patients suffer from neurocognitive deficits that correlate with local brain morphology in the frontal lobe and anterior cingulate gyrus, which may be interpreted to indicate structural correlates of pain-cognition interaction.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                epsic
                Estudos de Psicologia (Natal)
                Estud. psicol. (Natal)
                Programa de Pós-graduação em Psicologia e do Programa de Pós-graduação em Psicobiologia, Universidade Federal do Rio Grande do Norte (Natal, RN, Brazil )
                1413-294X
                1678-4669
                September 2017
                : 22
                : 3
                : 264-273
                Affiliations
                [03] orgnameUniversidade Federal de São Paulo
                [02] orgnamePrefeitura Municipal de Santos
                [01] orgnamePrefeitura Municipal de Santos
                Article
                S1413-294X2017000300003
                5687dcaa-2284-4778-81cf-ab13f828017c

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 06 October 2017
                : 07 May 2017
                : 29 August 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 49, Pages: 10
                Product

                SciELO Periódicos Eletrônicos em Psicologia


                fibromialgia,función ejecutiva,neuropsychology,fibromyalgia,executive function,neuropsicología,neuropsicologia,função executiva

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